FDA Adverse Event
Other
Summary report: N
MENTOR
MDR report key: 5402264
·
Received October 31, 2003
Report
- Report Number
- 5402264
- Event Type
- Other
- Date Received
- October 31, 2003
- Date of Event
- October 23, 2003
- Report Date
- October 23, 2003
- Manufacturer
- MENTOR
- Product Code
- FAE
- Report Source
- User Facility report
- Reporter Location
- FL, US
- Reporter Occupation
- 2
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | MENTOR | PENILE PROSTHESIS | FAE | MENTOR | ALPHA SCROTAL CYLIN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 79 YR | Other |